Effects of Early Care and Prenatal Risk on Behavior Problems, Self-Regulation, and Modulation of Physiological Stress Response in 6-7 Year Old Children of Intercountry Adoption

Purpose: Informed by teratology, attachment and stress theories, this cross-sectional, secondary dataset analysis examined three questions: 1) How does type of early care or 2) level of prenatal risk impact behavior problems, self-regulation, or modulation of physiological stress of intercountry adopted (ICA) children placed with their U.S. adoptive families for ≥ 3 years? And 3) are the effects of prenatal risk experiences on behavior problems, self-regulation, and physiological stress moderated by the type of early care children receive pre-adoption?

Methods: Early care comparisons were made between three groups matched on age (m = 6.9 years; SD = 0.6) and gender (girls n/group = 30) in children reared in institutional care (IC) (n = 40; m adoption age = 19 months; SD= 6.7 months), foster care (FC) (n = 40; m adoption age = 8.0 months; SD = 5.3), or birth family care (BC) (n= 40) on registry with the Minnesota International Adoption Project (N >2000 children). Adoptive parents provided child/family demographics, historical adoption and known prenatal risk information, completed behavior and temperament scales, and collected home baseline salivary cortisol samples. In the lab, children were tested on inhibitory control, attention regulation, and salivary cortisol. Analysis of Variance (ANOVA), independent samples t-tests, and Analysis of Covariance (ANCOVA) tested the individual effects of prenatal risk and early care on outcomes. Two-way ANCOVAs were used to investigate whether early care moderated prenatal risk on outcomes when controlling for adoption age.

Results: IC was older at adoption than FC and IC had experienced fewer prenatal risks than FC. Type of early care denoted significant differences between groups on behavior problems (IC > BC; n² = .09) and self-regulation (IC < BC; n² = .07); differences existed for lab cortisol baseline (IC < FC; n² = .04), but only without controlling for adoption age. Children with histories of high prenatal risk had greater behavior problems (High > Low; n²_p= .06) and elevated home cortisol baseline (High > Low; n²_p = .16) compared to low prenatal risk, even when controlling for adoption age and early care type. Early care type did not moderate the prenatal risk effects on developmental outcomes, indicating that the effects of prenatal risk were strong.

Implications. Early in life, children raised by responsive primary caregivers in family environments (BC; FC) are expected to have significantly fewer behavioral, self-regulation, and stress modulation problems than IC children. Yet, what emerged in this study were only differences between BC and IC groups, due to strong age-at-adoption influences. Prenatal risk effects lingered post adoption and remained significant when controlling for care type and adoption age. These effects were not moderated by care type. This may relate to children’s young ages at testing (6-7 years) and may change with maturation; to test this, future longitudinal studies are needed. This may reflect heterogeneity in IC and FC care quality. Greater collaboration is needed between social work, neuroscience, and stress research to inform child development, direct practice care, and a science-based framework for early childhood policy.